Orthopaedics, Traumatology and Prosthetics

Orthopaedics, Traumatology and Prosthetics

Basic info

  • Publisher: SYTENKO INSTITUTE OF SPINE AND JOINT PATHOLOGY
  • Country of publisher: ukraine
  • Date added to EuroPub: 2019/Sep/27

Subject and more

  • LCC Subject Category: Medicine, Research & Experimental, Orthopedics, Internal Medicine
  • Publisher's keywords: Medicine, Traumatology, Orthopaedics
  • Language of fulltext: russian, english, ukrainian
  • Time from submission to publication: 8 weeks

Publication charges

  • Article Processing Charges (APCs): No
  • Submission charges: No
  • Waiver policy for charges? No

Open access & licensing

  • Type of License: CC BY
  • License terms
  • Open Access Statement: Yes
  • Year open access content began: 2009
  • Does the author retain unrestricted copyright? True
  • Does the author retain publishing rights? True

Best practice polices

  • Permanent article identifier:
  • Content digitally archived in:
  • Deposit policy registered in: None

This journal has '63' articles

The nature and structure of pelvic area damage in patients with polytrauma andunstable pelvic ring

The nature and structure of pelvic area damage in patients with polytrauma andunstable pelvic ring

Authors: Nicolay Аnkin, Lev Аnkin, Vladimir Burluka, Andrey Tkachenko
Year: 2016, Volume: 602, Number: 1
(0 downloads)
Abstract

The goal: to investigate the nature and structure of the pelvic area injury (PAI) in casualties with severe concomitant injury and unstable pelvic ring. The methods: the medical records of 406 casualties (157 survivors, 249 dead) with an unstable pelvis injury in polytrauma were analyzed. The severity of the injury was assessed according to the integral scales ISS, PTS, ATS. The con­clusion forensic examinations were studied for the dead. Results: among different types of injury traffic accident (245; 60.3 %) and household injuries (136; 33.5 %) were predominated, from point of view of injury genesis — catatrauma (150; 36.9 %). Unstable pelvic injuries in polytrauma were diagnosed more than half of patients with PAI with a predominance of rotationally unstable fractures (type B) — 307 (75.6 %). Vertically unstable lesions (type C) were observed in 99 (24.4 %) cases. Concomitant acetabular fractures were observed in 11.8 % of patients, damage to the pelvic organs (PO) — in 24.1%. Among PO following ruptures were detected: bladder — 48 (11.8 %), urethra — 27 (6.7 %), rectum — 5 (1.2 %),uterus and ovarian — 3 (0.7 %), great vessels — 5 (1.2 %), sev­eral PO — 10 (2.5 %). The severity of the damage of the different anatomical regions (AR) according to the scales ISS, PTS, ATS in group of survivors and deaths did not differ significantly (p > 0.05),but from the point of view of general severity of injury the dif­ferences between the groups were significant (p < 0.05). Lethal outcome was recorded in 249 cases (61.3 %). The greatest number of casualties died at 1–3 days post-injury — 185 cases (74.3 %); 4–10-days — 42 cases (16.9 %), 10 days after trauma and more — 22 cases (8.8%). In 72 28.9 %) cases, the results of forensic medical examination did not match the final diagnosis of damage severity of pelvic ring injury. Conclusions: unstable pelvic injury (type B and C) in patients with polytrauma was identified in 51.9 %of cases, while rotationally unstable fractures (type B) — 2/3. Vertically unstable fracture (type C) increases the risk of death by almost two times. Crucial to survival prognosis in polytrauma has a number of damaged AR due to the development of mutual burdening syndrome.

Keywords: structure, polytrauma, pelvic area, instability of the pelvic ring
Anatomical large femoral heads: early complications and mid term results

Anatomical large femoral heads: early complications and mid term results

Authors: Alon Grundshtein, Ofir Chechik, Ran Schwarzkopf, Ely Steinberg, Oleg Dolkart, Shmuel Dekel, Nimrod Snir
Year: 2016, Volume: 602, Number: 1
(0 downloads)
Abstract

Purpose: mechanical complications such as malrestoration of hip anatomy still impede surgical results and patient satisfaction after THA. Anatomical femoral «mega-heads» are a novel approach which enables a surgeon to use a large diameter metal on metal implant to restore hip anatomy. Ability to place femoral head eccentrically on the femoral taper results in possible anteversion, retroversion, offset and lengthening. Our hypothesis is that use of this device will result in more accurate anatomical restoration and clinical results. Methods: 64 anatomical mega-head arthroplasties were evaluated. Preoperative planning was done in order to determine the desired position of the head, restore the anatomy and avoid leg lengthening. Patients were observed at an average of 50-months for both subjective and objective outcomes. Radiograph analysis assessed anatomical restoration. Results: 51 of the 64 hips were available for follow up. In 35 the head was placed eccentrically. In 20 the positioning was inferior, 6 — posterior, 3 — anterior, 1 — superior, and 4 inferior and posterior. Harris Hip and SF-36 scores improved significantly (P < 0.001). Mean radiographic limb and offset discrepancy were 0.1 and 0.01mm respectively. Six patients (11.7 %) underwent revision surgery; elevated metal ion levels and pseudotumor (3), acetabular component loosening (2), and unexplained hip pain (1). Conclusions: The novel anatomical femoral mega-head allows versatility in restoration of normal hip anatomy. Mid-term follow-up showed a higher than anticipated rate of complications for this cup design and reduced longevity of the implant. Novel ways need to be explored to allow such versatility in restoring hip anatomy.

Keywords: total hip arthroplasty; anatomical large head; anatomical center of rotation; mega-head; mid term results
Comparison of radiological and clinical assessments patellar resurfacing with retention for late stages of knee osteoarthritis performed total knee arthroplasty

Comparison of radiological and clinical assessments patellar resurfacing with retention for late stages of knee osteoarthritis performed total knee arthroplasty

Authors: Jong Keun Seon, Kamolhuja Eshnazarov, Murodulla Karimov, Eun Kyo Song
Year: 2016, Volume: 602, Number: 1
(0 downloads)
Abstract

Introduction: the purpose of this prospective study was to compare radiological and clinical outcomes after total knee arthroplasty (TKA) with or without patellar resurfacing in patients with grade IV osteoarthritis on patellofemoral joint. Materials and Methods: 123 cases with Kellgren-Lawrence grade IV osteoarthritis on patellofemoral joint were enrolled for this study. At the operating room they were randomly assigned to undergo patella resurfacing (62 cases) or patella retention (61 cases). Among them, 114 cases that could be followed for more than 2 years were included in this study (resurfacing group; 59 cases, retention group; 55 cases). Preoperative and postoperative radiological and clinical outcomes (mechanical femorotibial angles, patellar tilt, congruence angle, WOMAC score and ROM) were evaluated and compared between two groups. Results: preoperative radiological measures show insignificant difference between patellar tilt (P = 0.13), mechanical femorotibial angles (P = 0.62) and congruence angle (P = 0.37). Despite the difference performed methods of surgery, postopera­tive radiological assessment outcomes between two groups were almost identical Patellar tilt (P = 0.47), mechanical femorotibial angles (P = 0.34) and congruence angle (P >0.05). WOMAC score after surgery was 31.7 ± 6.4 point in resurfacing group, 29.2 ± 6.9point was in retention group without significant intergroup difference. And there was no significant difference ROM in both groups respectively. There was no significant difference between two groups in mechanical axis of the lower limb and patella tilt, patella congruence. Conclusion: obtained almost the same satisfactory radiological and clinical outcomes after patella resurfacing and retention groups after TKR allows us to conclude that, primary TKA without patellar resurfacing is a good treatment option in patients with high grade osteoarthritis of the patellofemoral joint.

Keywords: knee osteoarthritis; total knee arthroplasty; patella resurfacing; radiological assessment; clinical outcomes
The results of clinical application of the spring-loaded fixator in osteosynthesis of the medial fractures of femoral neck

The results of clinical application of the spring-loaded fixator in osteosynthesis of the medial fractures of femoral neck

Authors: Evgeny Pirogov, Olexiy Tyazhelov
Year: 2016, Volume: 602, Number: 1
(0 downloads)
Abstract

The share of femoral neck fractures in the structure of injuries enlarges every year due to increasing number of elderly people. Known techniques of osteosynthesis do not provide satisfactory results of treatment in the majority of patients with medial femoral neck fractures. The goal: to improve outcomes of treatment for the patients with medial femoral neck fractures through the development and introduction into clinical practice a new method of bone fragments connecting. The methods: a new device for osteosynthesis of medial femoral neck fractures was worked out and implemented into clinical practice; due to its design features this device can provide primary intertrfragmental compression during surgery and secondary due to potential energy of the compressed spring. A special mechanism of ratchet gearing provides unidirectional telescopic effect and prevents the formation of interfragmental diastase that allow to achieve spontaneous fracture stabilization in postoperative period even with substantial edge resorption of fragments. 114 patients (aged from 23 to 92 years) underwent 115 ope-rations using proposed device from February 2011 to July 2015. Results: positive results in the main clinical group, where proposed fixator was used, were obtained in 89 % cases. Conclusions: the device, that was worked out, is substentiated from anatomical-clinical positions and concepts of resorptive process within the remodeling of bone fragments. The technique is highly effective osteosynthesis even under adverse prognostic for bone-healing of medial femoral neck fractures (II–III type by Pauwels, III–IV typeby Garden) in patients of different age groups. Minimally invasive surgery technique enables organ-savings surgery for elderly patients, including those with co-morbidities.

Keywords: osteosynthesis of femoral neck; spring-loaded device with ratchet gears; marginal resorption of fragments
The definition of indication for the surgical treatment on menisci

The definition of indication for the surgical treatment on menisci

Authors: Elena Baburkina
Year: 2016, Volume: 602, Number: 1
(0 downloads)
Abstract

Pathology of knee menisci (KM) leads to osteoarthritis (OA) de­velopment in 20–40% in nearest 7–10 years after primary surgical treatment. The same situation is observed after the arthroscopic interventions. Goal of investigation: to show the most common tactical mistakes during the surgical interventions on menisci. Methods of investigation: the results of treatments of 131 patients with meniscus pathology of different genesis from 5 to 36 years after primary surgery. The patinets were divided into 3 groups: I (85 patietns) — meniscogenic syndrom, determined by congenital predisposition, II (19 patients) — traumatic injury of meniscus; III (7 patients) — pathic pathology. OA stages were determined according to Kellgren-Lawrence classification. Results: the most common mistakes in the meniscus surgery were determined. It was found out, that the worst results developed in the conditions of frontal deformity on knee level. The resection of meniscus under these circumstances increased OA development. The development of pain, in remote terms after operation, localized in anterior parts determined by the status of femur-patella joint. It was proved that if an angle of varus deformity on knee joint (KJ) is equal to 8°, pressure on medial meniscus is increased on 30.8 %, that provokes its disruption. Outcome: its necessary to assess KJ structure during the planning of meniscus surgery. Lateral X-ray view charcterizes the interrelationship between patella and distal femur joint surface contacting with patella, that play a large role for determing an abnormality of patella-femoral joint. MRI and CT are the modern methods of investigation, meanwhile they allow to assess meniscus damage only, but not the status of KJ in general. That is why these methods of investigation are just additional for the patients with meniscus abnormality.

Keywords: meniscus; arthroscopy; knee joint structure abnormality; treatment tactics
Evaluation of the prevalence of tumor lesions of the proximal femur on the basis of spiral computed tomography

Evaluation of the prevalence of tumor lesions of the proximal femur on the basis of spiral computed tomography

Authors: Oleg Vyrva, Roman Malyk, Yanina Golovina
Year: 2016, Volume: 602, Number: 1
(0 downloads)
Abstract

The affection of the proximal femur with malignant tumors ranked first in the case of metastatic lesions and the second - among all sites of primary malignant tumors of the long bones. Anatomically, this area is quite sophisticated and high accuracy of topical diagnosis and evaluation of tumors prevalence is required. Spiral computed tomography (SCT) provides an accurate representation of tumors spread to bone and surrounding soft tissues. The problems of development patterns of extra-osteal component of tumor in upper third of the arm, soft tissue reconstruction, restoration of joint function and limb as a whole. The goal: to investigate the features of lesions of bone and soft tissue structures in malignant tumors of the upper third of the thigh based SCT data. The methods: the results of SCT studies of 55 patients with lesions of the upper third of the femur with malignant tumors were selected for analysis. SCT results were analyzed according to the method that was designed to assess the prevalence of tumor process in the proximal femur. The method is based on the study of tumor growth along the thigh, the direction and extent of the tumor extra-osteal component in the horizontal plane. The results: a working classification of tumor dissemination in the proximal femur, depending on the extension of the tumor along a portion of the upper half of the thigh, the development direction and severity of tumor process in soft tissues is proposed. Conclusion: the proposed working classification will help to determine the possibility of surgical treatment of patients with malignant tumors of the upper third of femur, as well as to clarify the indications for different types of organ-saving surgical treatment of with soft tissue reconstructive procedures for femur and hip to improve functional outcomes of patient treatment.

Keywords: malignant bone tumors; proximal femur; spiral computed tomography
State of venous blood flow in the lower extremitiesof patients with fractures of the tibia after plate osteosynthesis

State of venous blood flow in the lower extremitiesof patients with fractures of the tibia after plate osteosynthesis

Authors: Dmitro Babun, Petro Zhuk
Year: 2016, Volume: 602, Number: 1
(0 downloads)
Abstract

Violation of antegrade blood flow, deep vein thrombosis and pulmo­nary embolism (PE) presents the complex problem in the treatment of trauma patients. The goal: to examine the state of antegrade blood flow in the vessels of lower extremities in patients with fractures of the long bones of lower leg after surgery using on-bone plates. The methods: clinical-laboratory and Doppler study of 56 pa-tients (33 men and 23 women aged from 19 to 62 years) were performed. Fractures in the lower third of the tibia were found in 17 (30.3 %) patients, in the middle third — in 29 (51.7 %), at the top — in 10 (18 %). All patients at different times after injury underwent an open reduction and fixation of bone fragments of leg bones with LCP-plates. The patients, who had such pathology as chronic thrombophlebitis, cardiovascular or cancer diseases, overweight or had a history of episodes of pulmonary embolism (PE) before injuries were not included in the study. Results: it was found that surgical treatment provokes considerable disturbances in the hemostatic system with the development of deep vein thrombosis of the injured limb. After the surgery, a positive test for D-dimer and a significant increase in the level of soluble fibrin-monomer complex was observed in 34 (60.7 %) patients, that was almost twice the number of such cases in preoperative period. Thrombosis of shin venous on the level of surgery with signs of flotation and proximal distribution was revealed on Doppler ultrasound investigation. Conclusions: the patients who have undergone surgery to stabilize bone fragments using LCP-plates, are at risk of pathological thrombus formation in the veins of the operated limb and the need for timely diagnosis and adequate treatment of this disease in order to avoid dangerous complications such as thrombotic disease of the lower extremities and pulmonary embolism (PE).

Keywords: fractures of long bones of the lower leg; metalosteosynthesis; on-bone plate; deep vein thrombosis; blood flow disturbance
Stress-strain state of the system "lumbar spine-sacrum-pelvis" in the conditions of front pelvis

Stress-strain state of the system "lumbar spine-sacrum-pelvis" in the conditions of front pelvis

Authors: Mykola Korzh, Volodymyr Staude, Andrey Kondratyev, Mykhaylo Karpinsky
Year: 2016, Volume: 602, Number: 1
(0 downloads)
Abstract

The goal: to analyze the stress-strain state of the sacroiliac joints with central, interosseous, dorsal sacroiliac ligaments in normal condition and in the conditions of pelvis tilt in the frontal plane. The methods: for this study virtual model was elected, it was synthesized on the base of CT scan of the lumbar spine, sacroiliac joints (SIJ) and pelvis of 20 patients and MRI of SIJ of 10 patients. Synthesized finite element models of lumbosacral spine and SIJ were loaded on the upper vertebrae LI along the axis of spine with compressive force that was equal to 400 and 2000 N. The results: obtained qualitative picture of the stress-strain distribution in the lumbosacral spine model during pelvic tilt suggest changes in the nature of work in all joints. Pelvis tilt causes additional compression on SIJ that located below (left). Being loaded sacrum provokes additional rotation around SIJ that located below (left). This leads to a shift of conventional axis of rotary pelvis motion forward and down on one side, back and top to bottom — on the other, that was accompanied by a significant increase in the relative compressive deformation of soft tissue structures of SIJ on one side (left). Under the conditions of loading (400 N) combined with pelvis tilt compared to its normal state an increase in tension values in all SIJ ligaments on left side was recorded especially in dorsal, interosseous, cross-iliac and iliac-lumbar ligaments. Relative deformity of hyaline cartilage increased significantly on the left side in interosseous ligaments towards compression direction. An increasing of loading up to 2000 N provided an increased role of sacro-tuber, sacro-spinous, iliac-lumbar ligaments where stresses value increased by 5–10 times. In this situation the values of relative tensile deformations also increases in ventral, interosseous, dorsal, iliac-transverse and iliac-lumbar ligaments on the right side.

Keywords: sacro-iliac joints; lumbar spine; sacrum; ligaments
Stress-strain state of fibrin-blood clot and periosteum in the area of diaphyseal fracture under different conditions of fracture fragments fixation and its impact on the structural organization of regenerate

Stress-strain state of fibrin-blood clot and periosteum in the area of diaphyseal fracture under different conditions of fracture fragments fixation and its impact on the structural organization of regenerate

Authors: Valeriy Litvishko, Olexii Popsuishapka, Oleksandr Yaresko
Year: 2016, Volume: 602, Number: 1
(0 downloads)
Abstract

The goal: using mathematical finite-element modeling to calculate the stress-strain state (SSS) of fibrin-blood clot and periosteum around the fracture zone in the conditions of fixation of femur fragments with on-bone plate, intramedullary locking nail and ExFix. The methods: the model represents two fragments of femur with transverse fracture plane joined with spindly fibrin-blood clot enclosed in periosteum and devices mentioned above. The existing data on the Young's modulus and Poisson's ratio of all components of the model were used. The calculations of SSS of clot and periosteum were performed under axial load of 800 N on femur and transverse load of 200 N on the distal femur. The control points on the horizontal section of clot and periosteum were selected for a quantitative comparison of the voltage in various conditions of fragments fixation. Moreover, the area covered by the maximum stress level was compared. The results: The following patterns were revealed. At the same axial load of model the lowest level of stress in periosteal-fibrin spindle was observed when fragments were fixed with intra­medullary locking nail, a little more — with plate, and the biggest one — with ExFix. The ratio of the stress values was 1: 2: 3–4.At the same transverse load of model the lowest level of stress in periosteal-fibrin spindle was observed when fragments were fixed with plate, a little more – with intramedullary locking nail, and the biggest one — with ExFix. The ratio of the stress values was 1: 6: 10–12.The greatest difference in stress levels was noticed in the conditions of transverse load on the segment. Conclusion: The presented data on SSS in tissues around the fracture zone explain the origin of sizes, shapes and structures of periosteal bone regenerate in the treatment of diaphyseal fractures with devices with different modes of mobility of bone fragments

Keywords: diaphyseal fractures, osteosynthesis, fibrin-blood clot, the stress-strain state
The strength of bone-metal block for different types of implants surfaces under the conditions of normal bone and osteoporosis in rats

The strength of bone-metal block for different types of implants surfaces under the conditions of normal bone and osteoporosis in rats

Authors: Volodymyr Filipenko, Mykhaylo Karpinsky, Olena Karpinska, Mandus Akonjom, Stanislav Bondarenko
Year: 2016, Volume: 602, Number: 1
(0 downloads)
Abstract

Fixing the acetabular component of prosthesis in the conditions of osteoporosis and changes in acetabulum anatomy is an actual problem of modern orthopedics. The goal: to perform a comparative analysis of the strength of bone-metal block for the different type of implant surfaces in the conditions ofnormal bone and in the simulation of osteoporosis in rats. The methods: experimental studies of femur strength were carried in 60 laboratory animals (rats). The animals were divided into two groups of 30 animals each: I — relatively healthy, II — osteoporosis induced by ovariectomy. 6 subgroups were formed in each group of animals. Implants of such differentmaterials as porous titanium, tantalum porous Trabecular Metal (Zimmer), titanium coated with Gription (DePuy), Stiktite (Smith & Nephew), Trabecular Titanium (Lima), Tritanum (Stryker) were used to fill a hole-like defect in distal metaphysis of femur. The animals were taken out of experiment 14 days after implanta­tion and biomechanical investigation was performed to assess the strength of operated and contralateral femurs. Longitudinal axial load using a metal rod was applied to femoral head. Load value gradually increased to complete destruction of anatomical specimen and measured. The results: femurs with implants from porous tantalum Trabecular Metal and Stiktitewith stood the maximum load in the conditions of normal bone density. Specimen of femurs with implanted porous titanium (the most weak) and tantalum Trabecular Metal (the most solid) composed separate subsets in the conditions of simulated osteoporosis. The conclusions: the comparative analysis of biomechanical investigation revealed that bone with implants from porous tantalum withstands the maximum breaking load in the conditions of normal and osteoporotic bone.

Keywords: implants surface, bone-metal block, osteointegration, joint replacement
The peculiarities of location of medial twigs of posterior branches of spinal nerves (topographic-anatomical studies)

The peculiarities of location of medial twigs of posterior branches of spinal nerves (topographic-anatomical studies)

Authors: Volodymyr Radchenko, Olexandr Perfiliev, Valery Larichev
Year: 2016, Volume: 602, Number: 1
(0 downloads)
Abstract

Unsatisfactory results afterthe interventional treatment of pain syndrome associated with lumbar spondyloarthrosis could be explained by underestimation of variants of location of posterior branches (PB) of spinal nerves (SN) and therefor by incomplete denervation of facet joints (FJ). The goal: to perform topographic-anatomic study of the medial branches PB SN in lumbar spine (LS) of human corpses and determine their size and variation of anatomical location in order to optimize minimally invasive diagnostic and treatment procedures. The methods: 8 corpses are investigated (6 males and 2 females, age from 45 to 86 years). All the corpses were not claimed for burial, the causes of death were not associated with pathology or trauma of spine. 40 vertebral-motor segments (VMS), i.e. 80 segments on both sides, were isolated from the corpses on the LI–SI levels of spine without blocks removal or violation of corpse shape. The results: it was found out that anatomic variation in LI–LV levels was equal to 15.6 %, in LV–SI — 25 %. Diameter of medial branch was equal to 340–760 microns. «Triangle of medial branches» of PB of SN in LS was determined. Its borders pass in segments LI–LV on the base of transverse process to 2/3 (bottom line), outer surface of superior articular process to 3/3 (medial) and line connecting apex 3/3 of superior articular and 2/3 of transverse process (top). In segments LV–SI inferior border passes on the base of sacrum wing to 2/3, medial — on outer surface of articular process to 3/3 and superior — on the line connecting apex of 3/3 of superior articular process and sacrum wing. The conclusions: a clear visualization of nerves, planned for the intersection, is required to perform a complete denervation of FJ. Using of specialized endoscopic equipment and taking into consideration the minimum necessary area to determine the bony landmarks VMS make it possible.

Keywords: medial twigs of posterior branches of spinal nerves; topographic-anatomical studies; facet joints
Morphological peculiarities of bone healing in the place of experimental cortical defect of long bone of rats in the conditions of naturalhydroxyapatite implantation

Morphological peculiarities of bone healing in the place of experimental cortical defect of long bone of rats in the conditions of naturalhydroxyapatite implantation

Authors: Olexiy Korenkov
Year: 2016, Volume: 602, Number: 1
(0 downloads)
Abstract

The goal: to investigate bone-healing process after implantation of osteoplastic material Cerabone® in compact bone defect. Methods: experiment was performed on 24 white rats (male). Hole-like defect (2.5 mm diameter) was created on the middle third of femur diaphysis using portable drill with spheric mill at low speed with cooling. The defect reached intramedullary canal; it was filled with osteoplastic material Cerabone® in experimental animals and was left unfilled in control. Bone fragments were studied on the 15th and 30th days using method of light microscopy with morphometry and scanning electron microscopy that was performed on electronic microscope «РЭМ 106-И». Morphometric analysis was carried out using image-processing programs «Видео-тест» and «Видео-размер». Results: it was found out that material Cerabone® did not provoke any inflammatory reaction. The lacunas with typical osteocytes were located in maternal bone adjacent to the site of transplantation. This fact gives the evidence of material biocompatibility. At all stages of study the signs of desmal osteogenesis only were identified, the presence of bone and connective tissues in defects in both groups pointed on this fact. Bone tissue of regenerate in animals of experimental and control groups on the 15th day took the form of large-loop and small-looped network of trabeculas. On 30th day the areas of bone similar in structure to maternal bone were found. The forming of bone regenerate with high density of osteoblasts and osteocytes was found in the animals of experimental group only on outer side of Cerabone® surface without penetration into osteoplastic material. The entire period of observation Cerabone® provided the stable volume of defect due to good integration with bone tissue of regenerate and absence of reliable signs of resorption.

Keywords: Cerabone®; hydroxyapatite; reparative osteogenesis; compact bone
Structural peculiarities of m. quadriceps of femur in experimental rats in the conditions of femur deformity forming

Structural peculiarities of m. quadriceps of femur in experimental rats in the conditions of femur deformity forming

Authors: Kostiantyn Romanenko, Nataliya Ashukina, Dmytro Prozorovsky
Year: 2016, Volume: 602, Number: 1
(0 downloads)
Abstract

Stable posttraumatic deformities of long bones lead to changes in interrelationships in damaged segments that could cause dysfunction of muscles and ligaments, joint surface integrity and range of motion in limb joints. The goal: to investigate in experiment on rats the structural peculiarities of muscles adjacent to peak of posttraumatic femur diaphysis deformity. Methods: varus deformity on the level of middle third of femur diaphysis was simulated on 15 white mature rats (age at the beginning of study — 6 moths). Preshaped K-wire (with appropriate size and angle 35°) was inserted in the intramedullary canal after transversal osteotomy to create deformity. Euthanasia was performed 1, 3 and 6 moths after operation followed by histological investigation. Results: 1 month after deformity modeling the most severe destructive changes were noticed in muscle fibers adjacent to the peak of deformity on convex side. Tortuosity, swelling, loss of cross striation, nucleus pycnosis with their migration towards the center of fibers, edema of endomysium and perimysium were found. The severity of destructive changes decreased at the distance of the zone of deformity modeling. 3 months after operation the most severe destructive changes in muscle fibers were observed on the convex side of deformity as well. 6 months after deformity modeling on the both convex and concave sides of deformed bone the structure of muscle fibers generally corresponded to the structure of muscle structure of intact animals of appropriate age. The absence of difference in the structure of muscles on convex and concave sides of deformity on this term caused by their restructuring as a reaction to prolonged stress. Conclusions: structural-function peculiarities of the muscle of injured extremity should be taken into consideration while planning the tactics of treatment of long bones posttraumatic treatment

Keywords:
The modern concept of diagnosis and treatment of gunshot and mine-explosive injuries of limbs

The modern concept of diagnosis and treatment of gunshot and mine-explosive injuries of limbs

Authors: Oleksandr Loskutov, Yaroslav Zarutskiy
Year: 2016, Volume: 603, Number: 2
(0 downloads)
Abstract

Purpose: to analyze medical care experience in the treatment of patients with limb wounds in the system of staged military treatment-evacuation supplying (TES) and to build up recommendation for common understanding in pathogenesis of gunshot and mine-explosing wounds, diagnostic principles and treatment. Methods: medical cases and accompanying documents of patients with wounded limbs treated in the hospital from May 2014 to December 2015. Wounds character, localization, severity, medical care and treatment at the different stages of evacuation were assessed. Results: upper and lower limbs wounds consist 62,5% out of general structure of sanitary loses. Among them 78,4% have soft tissue injuries, 21,6% — gunshot fractures. Characteristic feature of combat wound are the big part of combine and multiple injuries (32,1%), domination of splinter (62,9%) and mine-explosive (25,6%) injuries. The majority of the wounded with isolated and multiple wounds to extremities are slightly injured and represent a significant reserve of military personnel. Combat TES system involves the separation of medical care and treatment of limb wounds into separate stages in conjunction with the evacuation of victims. Conclusion: medial care and treatment wounded with limb injuries with gunshot and mine-explosive wounds is providing in the military system of TES. The main goal of treatment of gunshot wounds of extremities is to achieve an uncomplicated wound healing, healing of fractures and limb function recovery.Implementation of the basic TES system tasks is the returning the maximum number of wounded — should contribute to the effective organization of staged treatment slightly wounded in hospitals without their frontline evacuation to the rear of the country.

Keywords: combat injuries; gunshot fractures; stages of medical care; medical evacuation support
Analysis of surgical treatment of tibial fractures fractures during the antiterrorist operation

Analysis of surgical treatment of tibial fractures fractures during the antiterrorist operation

Authors: Sergii Korol
Year: 2016, Volume: 603, Number: 2
(0 downloads)
Abstract

Objective: To analyze the surgical procedures performed at all levels of medical care in the wounded with gunshot fractures of the tibia and severed limbs during the anti-terrorist operation (ATO). Methods:it is analyzed medical care in 118 wounded (May 2014–April 2015) with tibial gunshot fractures in 111 (94.07 %) and severed limbs — 7 (5.93 %). Results: in the wounded with tibial gunshot fractures and severed limbs temporary bleeding control, aseptic bandage application, pain management transport immobilization with improvised means provided at the primary and I medical care levels with following evacuation to the II level of the medical care. Beginning from the II level, all wounded underwent primary surgical treatment (PST). Osteosynthesis with external fixation device (EFD) performed in 76.27 % patients, revision surgical treatment (ST) — in 72.03 %, fasciotomy — in 23.73 %, free autodermoplasty — in 15.25 %, Ilizarov device osteosynthesis — in 15.25 %, amputation — in 10.17 %, nailing — in 8.47 %, plating — in 5.93 %, autogenous prosthesisng — in 5.08 %, VAC therapy — in 4.24 %, revision surgical treatment — 3.38 %. At the II level of medical care PST, final bleeding control, fasciotomy and stable fixation with external fixation device performed mainly. At the III and IV levels revision ST with VAC-therapy and ultrasound cavitation executed. After the soft tissue healing with the inflammation signs absence in 14.40 % patients external fixation device changed to the plate or nail. After 6–12 month good functional results obtained in 54.31 % of patients, satisfactory — in 30,17 %, unsatisfactory — in 15.52 %. Organizational, treatment and diagnostic mistakes were analyzed.

Keywords: medical therapies; medical care levels; gunshot tibial fractures; mine-explosive injury; severed limbs

About Europub

EuroPub is a comprehensive, multipurpose database covering scholarly literature, with indexed records from active, authoritative journals, and indexes articles from journals all over the world. The result is an exhaustive database that assists research in every field. Easy access to a vast database at one place, reduces searching and data reviewing time considerably and helps authors in preparing new articles to a great extent. EuroPub aims at increasing the visibility of open access scholarly journals, thereby promoting their increased usage and impact.